scholarly journals Association of Antihyperglycemic Therapy with Risk of Atrial Fibrillation and Stroke in Diabetic Patients

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 592 ◽  
Author(s):  
Cristina-Mihaela Lăcătușu ◽  
Elena-Daniela Grigorescu ◽  
Cristian Stătescu ◽  
Radu Andy Sascău ◽  
Alina Onofriescu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Glycemic Control ◽  
Medical Literature ◽  
Diabetic Patients ◽  
Antidiabetic Agents ◽  
Cerebrovascular Events ◽  
Antihyperglycemic Therapy ◽  
Increased Risk ◽  
Patients With Diabetes

Type 2 diabetes mellitus (DM) is associated with an increased risk of cardiovascular disease (CVD). Atrial fibrillation (AF) and stroke are both forms of CVD that have major consequences in terms of disabilities and death among patients with diabetes; however, they are less present in the preoccupations of scientific researchers as a primary endpoint of clinical trials. Several publications have found DM to be associated with a higher risk for both AF and stroke; some of the main drugs used for glycemic control have been found to carry either increased, or decreased risks for AF or for stroke in DM patients. Given the risk for thromboembolic cerebrovascular events seen in AF patients, the question arises as to whether stroke and AF occurring with modified incidences in diabetic individuals under therapy with various classes of antihyperglycemic medications are interrelated and should be considered as a whole. At present, the medical literature lacks studies specifically designed to investigate a cause–effect relationship between the incidences of AF and stroke driven by different antidiabetic agents. In default of such proof, we reviewed the existing evidence correlating the major classes of glucose-controlling drugs with their associated risks for AF and stroke; however, supplementary proof is needed to explore a hypothetically causal relationship between these two, both of which display peculiar features in the setting of specific drug therapies for glycemic control.

scholarly journals Sodium-glucose co-transporter 2 inhibition as a mitochondrial therapy for atrial fibrillation in patients with diabetes?

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Salva R. Yurista ◽  
Herman H. W. Silljé ◽  
Michiel Rienstra ◽  
Rudolf A. de Boer ◽  
B. Daan Westenbrink
Keyword(s):  
Atrial Fibrillation ◽  
Mitochondrial Dysfunction ◽  
High Fat Diet ◽  
Antiarrhythmic Drugs ◽  
New Class ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Series Of Experiments ◽  
New Evidence

AbstractWhile patients with type 2 diabetes mellitus (T2DM) are at increased risk to develop atrial fibrillation (AF), the mechanistic link between T2DM and AF-susceptibility remains unclear. Common co-morbidities of T2DM, particularly hypertension, may drive AF in the setting of T2DM. But direct mechanisms may also explain this relation, at least in part. In this regard, recent evidence suggests that mitochondrial dysfunction drives structural, electrical and contractile remodelling of atrial tissue in patients T2DM. Mitochondrial dysfunction may therefore be the mechanistic link between T2DM and AF and could also serve as a therapeutic target. An elegant series of experiments published in Cardiovascular Diabetology provide compelling new evidence to support this hypothesis. Using a model of high fat diet (HFD) and low-dose streptozotocin (STZ) injection, Shao et al. provide data that demonstrate a direct association between mitochondrial dysfunction and the susceptibility to develop AF. But the authors also demonstrated that the sodium-glucose co-transporter 2 inhibitors (SGLT2i) empagliflozin has the capacity to restore mitochondrial function, ameliorate electrical and structural remodelling and prevent AF. These findings provide a new horizon in which mitochondrial targeted therapies could serve as a new class of antiarrhythmic drugs.

The Challenge of Lipid Management in Patients with Diabetes or Other Endocrine Disorders

2010 ◽  
Vol 7 (2) ◽  
pp. 92
Author(s):  
Alberico L Catapano ◽  
Liliana Grigore ◽  
Angela Pirillo ◽  
◽  
◽  
...  
Keyword(s):  
Statin Therapy ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Lipid Management ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Associated Risk Factors

Diabetes increases the risk of developing cardiovascular disease (CVD), and several guidelines suggest that subjects with diabetes are at high risk of developing CVD. The increased risk can be attributed, at least in part, to associated risk factors, including hypertension and dyslipidaemia. The role of statins in primary and secondary prevention of CVD is well established, and the positive effect has been clearly demonstrated also in patients with type 2 diabetes. A number of studies have evaluated the effect of statin therapy on incident CVD and shown that statin therapy produces a great reduction in cardiovascular risk, but a recent meta-analysis revealed a slight increase in the risk of developing diabetes. Such risk is, however, low, especially when compared with the reduction in cardiovascular events and should not interfere with the choice of treating diabetic patients with a cholesterol-lowering therapy.

The Role of Anti-obesity Drugs in Patients with Type 2 Diabetes

2013 ◽  
Vol 09 (02) ◽  
pp. 101 ◽  
Author(s):  
Priscilla Hollander ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Lifestyle Changes ◽  
Important Concern ◽  
Increased Risk ◽  
The Us ◽  
Patients With Diabetes ◽  
Obesity Drugs

The prevalence of diabetes continues to rise, following the rising rates of obesity. Obesity is not only associated with an increased risk for developing type 2 diabetes but also an elevated probability of developing long-term complications associated with the disease. Weight gain is also an important concern as a potential side effect of therapies that improve glycemic control in diabetes, including insulin therapy. As a result, patients with type 2 diabetes are at risk for a vicious circle of increasing weight and increasing insulin resistance, thus requiring further intensification of glycemic treatment. It is therefore important to address the problem of obesity in patients with type 2 diabetes. In 2012, the US Food and Drug Administration (FDA) approved two new anti-obesity medications: lorcaserin and phentermine/topiramate extended-release. Both agents have demonstrated clinically meaningful weight reduction as well as significant improvements in glycemic control in obese patients with diabetes. Liraglutide has also shown weight loss and improvements in glycemic control in patients with diabetes. Anti-obesity drugs, in conjunction with lifestyle changes, may play a valuable role in the management of diabetes.

scholarly journals Metformin Is Associated with a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared to Sulfonylureas: An Observational Study

2021 ◽  
Author(s):  
Anna Ostropolets ◽  
Pierre A. Elias ◽  
Michael V. Reyes ◽  
Elaine Y. Wan ◽  
Utpal B. Pajvani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Diabetic Patients ◽  
Atrial Arrhythmias ◽  
Metformin Monotherapy ◽  
Increased Risk ◽  
Chronic Disorders ◽  
Reduced Risk

Background - Type 2 diabetes (DM2) is one of the most common chronic disorders worldwide and is an important cause of cardiovascular disease. Studies investigating the risk of atrial and ventricular arrhythmias in diabetic patients taking different oral diabetes medications are sparse. Methods - We used IBM MarketScan® Medicare Supplemental Database to examine the risk of arrhythmias for patients on different oral diabetes medications by propensity score matching. Results - We found that patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, including atrial fibrillation, compared to monotherapy with DPP4 or TZD medications. Patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, ventricular arrhythmias, and bradycardia compared to monotherapy with sulfonylureas. Combination therapy with sulfonylureas and metformin had an increased risk of atrial arrhythmias compared to some other combinations. Conclusions - Different oral diabetes medications have significantly different long-term risk of arrhythmia. Specifically, metformin is associated with reduced risk of atrial fibrillation and ventricular arrhythmias compared to sulfonylureas.

scholarly journals Application of artificial intelligence in prediction of cardiovascular complications in patients with diabetes mellitus type 2: A protocol of systematic review

2021 ◽  
Author(s):  
Hengameh Ferdosian ◽  
◽  
Hadi Zamanian ◽  
Sayed Ali Emami ◽  
Elahe Sedighi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Microvascular Complications ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Review Question

Review question / Objective: The aim of this systematic review is to evaluate AI-based models in identifying predictors of cardiovascular events and risk predtion in patients with diabetes mellitus type2. Condition being studied: T2DM patients have an increased risk of macrovascular and microvascular complications, lead to decreased quality of life and mortality. Considering the significance of cardiovascular complications in these patients, prediction of such events would be important. Different traditional statistical methods(such as regression) and new AI-besed algorithms are used to predict these complications in diabetic patients.

scholarly journals A patient with atrial fibrillation and diabetes: selecting the optimal anticoagulant therapy regimen

2021 ◽  
Vol 26 (5) ◽  
pp. 4508
Author(s):  
A. G. Obrezan ◽  
A. E. Filippov ◽  
A. A. Obrezan
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Risk Scores ◽  
Bleeding Events ◽  
Therapy Regimen ◽  
Severe Diabetes ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Artery Disease

Atrial fibrillation (AF) is a common arrhythmia in patients with type 2 diabetes (T2D). Patients with diabetes are at higher risk of AF than those without it. There is an increased risk of dysglycemia in AF. Patients with AF and concomitant diabetes are more likely to have coronary artery disease, hypertension, heart failure, while strokes in patients with AF and diabetes are more severe. Diabetes, in turn, causes the angiopathies and cardiopathy. There is a higher risk of both thrombotic and bleeding events in patients with AF and T2D. The article discusses the mutual burden of T2D and AF, as well as the risk scores for thrombotic, thromboembolic, and bleeding events. Anticoagulant therapy takes a special place in improving the prognosis in AF patients. Numerous studies and actual clinical practice have demonstrated the effectiveness of anticoagulants in the prevention of stroke and other comorbidities.

scholarly journals The Effects of Exenatide Once Weekly (EXQW) and Exenatide Twice a Day (EXBID) on Beta-Cell Function in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Jie Wang ◽  
Xinye Jin ◽  
Ping An ◽  
Songyan Yu ◽  
Yiming Mu
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Cell Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Antidiabetic Agents ◽  
Significant Difference ◽  
Glucagon Like Peptide 1

Background. In patients with type 2 diabetes mellitus (T2DM) and poor glycemic control receiving metformin (MET), glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are recommended as the adjunctive therapy. However, there are only a few studies involving the comparative effects of exenatide twice a day (EXBID) and exenatide once weekly (EXQW) on HOMA-β. This meta assessed the comparative effects of EXQW and EXBID on HOMA-β among T2DM patients. Materials and Methods. PubMed, Cochrane Library, and Embase databases were searched to collect randomized controlled trials (RCTs). Network meta-analysis was performed, and network diagrams were constructed to evaluate the effects. The primary outcome is HOMA-β, and the secondary outcomes are fasting blood glycose (FBG), glycated hemoglobin (HbA1c), and weight loss. Results. A total of 8 studies with 3506 subjects were included. Compared with other antidiabetic agents, EXQW has a greater improvement in HOMA-β than EXBID (weight mean difference WMD=‐0.46, 95% confidence interval (CI) [-0.64, -0.28], P=0.001). The effect of EXQW on HbA1c is superior to that of sitagliptin (SITA) (WMD=0.51, 95% CI [0.03, 0.99], P=0.037). The significant reduction of weight was detected for EXBID in comparison with EXQW (WMD=‐0.73, 95% CI [-1.13, -0.33], P=0.001), and no significant difference was found between EXQW and MET. Conclusions. EXQW shows a greater improvement in HOMA-β than EXBID. Moreover, the efficacy of EXQW on glycemic control is similar to other antidiabetic agents including EXBID. It is an advisable treatment for diabetic patients to improve HOMA-β and has an advantage of fewer number of injections compared with EXBID, to increase patients’ adherence and quality of life.

scholarly journals Effects of Type 2 Diabetic Serum on Proliferation and Osteogenic Differentiation of Mesenchymal Stem Cells

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Xiangqun Deng ◽  
Min Xu ◽  
Moyu Shen ◽  
Jinluo Cheng
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Glycemic Control ◽  
Osteogenic Differentiation ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Diabetic Osteoporosis ◽  
Type 2 Diabetic ◽  
Different Levels

Diabetic patients have an increased risk of osteoporosis-associated fractures. However, the results of most studies of the effects of diabetes on bone mass in patients with type 2 diabetes (T2DM) have been contradictory. To clarify these conflicting findings, we investigated the effects of diabetic serum on the proliferation and osteogenic differentiation of mesenchymal stem cells (MSCs). We used human sera from subjects with different levels of glycemic control to culture the MSCs and induce osteogenic differentiation. The rate of MSC proliferation differed when MSCs were cultured with sera from diabetic subjects with different levels of hyperglycemia. Hyperglycemic sera promoted MSC proliferation to some extent, but all the diabetic sera inhibited the differentiation of MSCs to osteoblasts. The effects of type 2 diabetic sera on the proliferation and osteogenic differentiation of MSCs are closely related to glycemic control. Our data demonstrate the importance of stratifying the study population according to glycemic control in clinical research into diabetic osteoporosis.

scholarly journals Association of ACE2 variant rs4646188 with the risks of atrial fibrillation and cardioembolic stroke in Uygur patients with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Liu ◽  
Jingxian Pei ◽  
Yanxian Lai ◽  
Tianwang Guan ◽  
Abudurexiti Zeyaweiding ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Left Atrial ◽  
Cardioembolic Stroke ◽  
Diabetic Patients ◽  
Ang Ii ◽  
Prevention Strategies ◽  
Angiotensin Converting Enzyme 2 ◽  
Increased Risk

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Type 2 diabetes (T2D) is an independent risk factor for AF. The cardioembolic stroke (CS) risk is increased when both conditions coexist. Whether angiotensin-converting enzyme 2 (ACE2) genetic variants predict increased risks AF and CS in Uygur patients with T2D remain elusive. Methods A total of 547 Uygur subjects (272 controls and 275 T2D patients) were recruited to the study from south Xinjiang. Eight ACE2 variants were identified by MassARRAY system. Results ACE2 rs2074192 (CC, adjusted RR = 2.55, 95% CI 1.35–4.80, P = 0.004), rs4240157 (CC + CT, adjusted RR = 2.26, 95% CI 1.27–4.04, P = 0.006) and rs4646188 (TT, adjusted RR = 2.37, 95% CI 1.16–4.86, P = 0.018) were associated with higher AF risk. ACE2 rs4240157 (CC + CT, adjusted RR = 2.68, 95% CI 1.36–5.27, P = 0.004) and rs4646188 (TT, adjusted RR = 2.56, 95% CI 1.06–6.20, P = 0.037) were further associated with higher CS risk. The 3 ACE2 variants were related to larger left atrial end-systolic diameter (LAD) (all P < 0.05), but not all of the 3 ACE2 variants were related to increased levels of serum sodium (rs4240157 and rs4646188, all P < 0.05), HsCRP (rs4240157 and rs4646188, all P < 0.05) as well as decreased serum potassium levels (rs2074192 and rs4646188, all P < 0.05). The 3 ACE2 variants exhibited heterogeneity on circulating RAAS activation. In particular, ACE2 rs4646188 was associated with higher levels of ACE (P = 0.017 and 0.037), Ang I (P = 0.002 and 0.001), Ang II (both P < 0.001) and ALD (P = 0.005 and 0.011). Conclusion These results indicated ACE2 rs4646188 was associated with increased risk of AF and CS among diabetic patients in Uygurs, which could be a promising genetic predisposition marker for early and personalized prevention strategies for the aforementioned clinical pathologies.

scholarly journals The Influence of Type 2 Diabetes and Glucose-Lowering Therapies on Cancer Risk in the Taiwanese

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ming-Chia Hsieh ◽  
Tzu-Chi Lee ◽  
Shu-Min Cheng ◽  
Shih-Te Tu ◽  
Ming-Hong Yen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Cancer ◽  
Cancer Risk ◽  
Insulin Treatment ◽  
Diabetic Patients ◽  
Glucose Lowering ◽  
Research Institutes ◽  
Increased Risk ◽  
Patients With Diabetes

Objective. To investigate the association between type 2 diabetes, glucose-lowering therapies (monotherapy with either metformin, sulphonylurea or insulin) and cancer risk in Taiwan.Methods. Using Taiwan’s National Health Research Institutes database of 1,000,000 random subjects from 2000–2008, we found 61777 patients with type 2 diabetes (age ≥20 years) and 677378 enrollees with no record of diabetes.Results. After adjusting for age and sex, we found patients with diabetes to have significantly higher risk of all cancers (OR: 1.176; 95% CI: 1.149–1.204,P<0.001). Diabetic patients treated with insulin or sulfonylureas had significantly higher risk of all cancers, compared to those treated with metformin (OR: 1.583; 95% CI: 1.389–1.805,P<0.001and OR: 1.784; 95% CI: 1.406–2.262,P<0.001). Metformin treatment was associated with a decreased risk of colon and liver cancer compared to sulphonylureas or insulin treatment. Sulfonylureas treatment was associated with an increased risk of breast and lung cancer compared to metformin therapy.Conclusions. Taiwanese with type 2 diabetes are at a high risk of breast, prostate, colon, lung, liver and pancreatic cancer. Those treated with insulin or sulfonylureas monotherapy are more likely to develop colon and liver cancer than those treated with metformin.

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